Bedwetting: At what age should you seek help?

Up to 500,000 children wet the bed in France and 7 million in the United States. However, bedwetting is not considered abnormal until the child reaches the age of 5. If the child is still wetting the bed at the age of 6, parents should seek help. When to intervene? Children over the age of 6 who attend sleepovers often want to be treated for social reasons, and this is a good reason to begin treatment. It may not be medically necessary to treat bedwetting after the age of 6, but peer pressure plays a significant role in a child's behavior. It is around the age of six that social factors begin to play a greater role in a child's life. How to help? Because currently prescribed medications for bedwetting can have side effects, urologists and pediatricians recommend a change in the child's routine. Experts say the safest, and most effective, form of therapy is to modify habits to promote a dry bed. Dean Cloward, a child psychologist practicing in Rigby, Idaho, offers some suggestions. Parents can start by limiting fluids after dinner. This may be enough for some children, but even if it fails, it's wise to continue this routine after other treatments have begun. The child should also empty his bladder just before bedtime. Waking the child at night to take them to the bathroom can help, but only if it doesn't disrupt the parent's and child's sleep patterns. The child wets the bed around the same time every night. You may want to wake the child just before that time to take them to the bathroom. Often the child is too deeply asleep to be woken, and sometimes too deeply asleep to get up to urinate, but it works for some. Other approaches can be devised, but they should be created and initiated by a child psychologist." "This is to ensure that other damaging effects of bedwetting don't affect the child and that the intervention helps rather than harms." In extreme cases, it's also important to find a child psychologist who specializes in bedwetting. Positive reinforcement can help children focus on staying dry, but it doesn't work in all situations. Some children need to be taught ways to control their bladder. In these cases, reinforcement is the best intervention. Creating a chart where the child can add a sticker each morning without incident is a good start. Using disposable underwear can be helpful while you're working on bedwetting. These underwear, which look like regular underwear, save the child the embarrassment of waking up to wet sheets and save the parents from having to do the laundry all the time. Not feeling the shame of being wet can boost the child's self-esteem. Medications as a last resort Some families who have exhausted less radical approaches to treating bedwetting may want to try medication. There are currently three recommended medications on the market. Using one type of antidepressant can help just over 10% of children. Side effects can include mood swings and nightmares, and, according to Dr. Cummings, there can be more serious side effects such as poor sleep and irritability. There is also a risk of cardiac arrhythmia. A bladder antispasmodic is also effective in half of children but can cause facial flushing, irritability, and even heat exhaustion. Children taking medication should drink plenty of water during the summer months. Doctors may also prescribe a synthetic version of vasopressin, an important regulating hormone that our bodies normally produce. This medication recycles the water in urine back into the bloodstream so that the child produces less urine at night. Children should be monitored closely while taking either of these medications, and dosages should not be increased without a doctor's instructions. Dr. Loening-Baucke believes parents would be better off trying to change their routine before giving their children medication. When therapy fails A failed therapy does not indicate a major problem, since none of these therapies works more than 50 to 60% of the time. Worrisome symptoms to look for in children with bedwetting include: Daytime incontinence The onset of symptoms after a long period without problems The presence of urinary tract infection If your child has experienced these types of problems, it is recommended that they be examined by a urologist. Parents and children dealing with bedwetting may be reassured to know that young bladders develop slowly. Each year, five to seven million children experience this problem, which they outgrow as they grow. One day, the child will wake up dry. Until then, stay calm, make some changes, and focus on what matters most in life—your family.